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Bronchoalveolar lavage (BAL), also known as bronchoalveolar washing, is a diagnostic method of the lower respiratory system in which a bronchoscope is passed through the mouth or nose into an appropriate airway in the lungs, with a measured amount of fluid introduced and then collected for examination.
Lipid-laden alveolar macrophages in a case of vaping-associated pulmonary injury.Left: Papanicolaou stain; right: Oil Red O stain. [1]Lipid-laden alveolar macrophages, also known as pulmonary foam cells, [2] are cells found in bronchoalveolar lavage (BAL) specimens that consist of macrophages containing deposits of lipids (fats). [3]
Obtaining targeted deep respiratory samples by bronchoalveolar lavage or protected specimen brush for the diagnosis or exclusion of pneumonia; Evaluation of alveolar cytopathology to identify inflammatory conditions or Alveolar haemorrhage; Direct inspection of the tracheal muscoa for pulmonary aspergillosis or similar invasive mould infections
Lung washings or tissue for histopathologic analysis are most commonly obtained using bronchoalveolar lavage and/or lung biopsy. [13] Characteristic biopsy findings show filling of the alveoli (and sometimes terminal bronchioles) with an amorphous eosinophilic material, which stains strongly positive on PAS stain and the PAS diastase stain.
Since laboratory testing, imaging, and bronchoalveolar lavage results are often non-specific, guidelines recommend surgical biopsy to diagnose desquamative interstitial pneumonia if high-resolution computed tomography does not reveal classic signs of interstitial pneumonia. [17] A definitive diagnosis of DIP relies on a lung biopsy. [18]
In patients incapable of producing a sputum sample, common alternative sample sources for diagnosing pulmonary tuberculosis include gastric washings, laryngeal swab, bronchoscopy (with bronchoalveolar lavage, bronchial washings, and/or transbronchial biopsy), and fine needle aspiration (transtracheal or transbronchial
The bronchoalveolar lavage in organizing pneumonia shows a lymphocytic predominant inflammation of the alveoli with increases in neutrophils and eosinophils. [9] Resolution of inflammatory cells in the bronchoalveolar lavage is usually delayed in organizing pneumonia, lagging behind clinical and radiographic improvement.
Whole lung lavage (WLL), also called lung washing, is a medical procedure in which the patient's lungs are washed with saline (salt water) by filling and draining repeatedly. It is used to treat pulmonary alveolar proteinosis , in which excess lung surfactant proteins prevent the patient from breathing.